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ACROSS SESSIONS
- Subject Index: Since 1995
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Developed and maintained by the Division of Legislative Automated Systems.
2016 SESSION
16101366DBe it enacted by the General Assembly of Virginia:
1. That §§ 2.2-426, 2.2-3114, 2.2-3115, 2.2-3116, as it is currently effective and as it shall become effective, 2.2-3117, 2.2-3118, 30-110, 30-111, and 30-356 of the Code of Virginia are amended and reenacted as follows:
§ 2.2-426. Lobbyist reporting; penalty.
A. Each lobbyist shall file with the Council a separate semiannual report of expenditures, including gifts, for each principal for whom he lobbies by December 15 for the preceding six-month period complete through the last day of October and June 15 for the preceding six-month period complete through the last day of April.
B. Each principal who expends more than $500 to employ or compensate multiple lobbyists shall be responsible for filing a consolidated lobbyist report pursuant to this section in any case in which the lobbyists are each exempt under the provisions of subdivision 7 or 8 of § 2.2-420 from the reporting requirements of this section.
C. (Effective January 1, 2016, through July 1, 2016) The
report shall be on a form provided prescribed
by the Council, which shall be substantially similar to the
following and shall be accompanied by instructions provided by the
Council.
C. (Effective July 1, 2016) The report shall be on a form
provided prescribed by the Council,
which shall be substantially similar to the following and shall be
accompanied by instructions provided by the Council. All reports shall be
submitted electronically and in accordance with the standards approved by the
Council pursuant to the provisions of § 30-356.
LOBBYIST'S DISCLOSURE STATEMENT
PART I:
(1) PRINCIPAL: _____________________________________________________
In Part I, item 2a, provide the name of the individual
authorizing your employment as a lobbyist. The lobbyist filing
this statement MAY NOT list his name in item 2a.
(2a) Name: __________________________________________________________
(2b) Permanent Business Address: ____________________________________
(2c) Business Telephone: ____________________________________________
(3) Provide a list of executive and legislative actions (with as
much specificity as possible) for which you lobbied and a
description of activities conducted.
________________________________________________________________
________________________________________________________________
________________________________________________________________
(4) INCORPORATED FILINGS: If you are filing an incorporated
disclosure statement, please complete the following:
Individual filing financial information: _______________________
Individuals to be included in the filing: ______________________
________________________________________________________________
(5) Please indicate which schedules will be attached to your
disclosure statement:
[ ] Schedule A: Entertainment Expenses
[ ] Schedule B: Gifts
[ ] Schedule C: Other Expenses
(6) EXPENDITURE TOTALS:
a) ENTERTAINMENT ..................................... $ ______
b) GIFTS ............................................. $ ______
c) COMMUNICATIONS .................................... $ ______
d) PERSONAL LIVING AND TRAVEL EXPENSES ............... $ ______
e) COMPENSATION OF LOBBYISTS ......................... $ ______
f) HONORARIA ......................................... $ ______
g) OTHER ............................................. $ ______
TOTAL ................................................ $ ______
PART II:
(1a) NAME OF LOBBYIST: ______________________________________________
(1b) Permanent Business Address: ____________________________________
(1c) Business Telephone: ____________________________________________
(2) As a lobbyist, you are (check one)
[ ] EMPLOYED (on the payroll of the principal)
[ ] RETAINED (not on the payroll of the principal, however
compensated)
[ ] NOT COMPENSATED (not compensated; expenses may be reimbursed)
(3) List all lobbyists other than yourself who registered to
represent your principal.
________________________________________________________________
________________________________________________________________
________________________________________________________________
(4) If you selected "EMPLOYED" as your answer to Part II, item 2,
provide your job title.
________________________________________________________________
PLEASE NOTE: Some lobbyists are not individually compensated for
lobbying activities. This may occur when several members of a firm
represent a single principal. The principal, in turn, makes a single
payment to the firm. If this describes your situation, do not answer
Part II, items 5a and 5b. Instead, complete Part III, items 1 and 2.
(5a) What was the DOLLAR AMOUNT OF YOUR COMPENSATION as a lobbyist?
(If you have job responsibilities other than those involving
lobbying, you may have to prorate to determine the part of your
salary attributable to your lobbying activities.) Transfer your
answer to this item to Part I, item 6e.
(5b) Explain how you arrived at your answer to Part II, item 5a.
________________________________________________________________
________________________________________________________________
________________________________________________________________
PART III:
PLEASE NOTE: If you answered Part II, items 5a and 5b, you WILL NOT
complete this section.
(1) List all members of your firm, organization, association,
corporation, or other entity who furnished lobbying services to
your principal.
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
(2) Indicate the total amount paid to your firm, organization,
association, corporation, or other entity for services rendered.
Transfer your answer to this item to Part I, item 6e. ___________
SCHEDULE A
ENTERTAINMENT EXPENSES
PLEASE NOTE: Any single entertainment event included in the expense
totals of the principal, with a value greater than $50, should be
itemized below. Transfer any totals from this schedule to Part I,
item 6a. (Please duplicate as needed.)
Date and Location of Event:
_____________________________________________________________________
_____________________________________________________________________
Description of Event (including whether or not it meets the criteria
of a widely attended event):
_____________________________________________________________________
_____________________________________________________________________
Total Number of Persons Attending:
_____________________________________________________________________
Names of Legislative and Executive Officials or Members of Their
Immediate Families Attending: (List names only if the average value
for each person attending the event was greater than $50.)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Food ...................................................... $ ______
Beverages ................................................. $ ______
Transportation of Legislative and Executive Officials
or Members of Their Immediate Families .................... $ ______
Lodging of Legislative and Executive Officials or
Members of Their Immediate Families ....................... $ ______
Performers, Speakers, Etc. ................................ $ ______
Displays .................................................. $ ______
Rentals ................................................... $ ______
Service Personnel ......................................... $ ______
Miscellaneous ............................................. $ ______
TOTAL ..................................................... $ ______
SCHEDULE B
GIFTS
PLEASE NOTE: Any single gift reported in the expense totals of the
principal, with a value greater than $50, should be itemized below.
(Report meals, entertainment and travel under Schedule A.) Transfer
any totals from this schedule to Part I, item 6b. (Please duplicate
as needed.)
Name of each
legislative or
executive official
or member of his
immediate family Cost of
Date Description who is a recipient individual
of gift: of gift: of a gift: gift:
___________ __________________ ______________________ $ __________
___________ __________________ ______________________ $ __________
___________ __________________ ______________________ $ __________
___________ __________________ ______________________ $ __________
TOTAL COST TO PRINCIPAL ............................... $ __________
SCHEDULE C
OTHER EXPENSES
PLEASE NOTE: This section is provided for any lobbying-related
expenses not covered in Part I, items 6a - 6f. An example of an
expenditure to be listed on schedule C would be the rental of a
bill box during the General Assembly session. Transfer the total
from this schedule to Part I, item 6g. (Please duplicate as needed.)
DATE OF EXPENSE DESCRIPTION OF EXPENSE AMOUNT
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
__________________ ________________________________ $ __________
TOTAL "OTHER" EXPENSES _____________________________ $ __________
PART IV: STATEMENTS
The following items are mandatory and if they are not properly
completed, the entire filing will be rejected and returned to
the lobbyist:
(1) All signatures on the statement must be ORIGINAL in the format
specified in the instructions provided by the Council that
accompany this form. No stamps, or other reproductions of the
individual's signature will be accepted.
(2) An individual MAY NOT sign the disclosure statement as lobbyist
and principal officer.
STATEMENT OF LOBBYIST
I, the undersigned registered lobbyist, do state that the information
furnished on this disclosure statement and on all accompanying
attachments required to be made thereto is, to the best of my
knowledge and belief, complete and accurate.
________________________
Signature of lobbyist
________________________
Date
STATEMENT OF PRINCIPAL
I, the undersigned principal (or an authorized official thereof), do
state that the information furnished on this disclosure statement
and on all accompanying attachments required to be made thereto is,
to the best of my knowledge and belief, complete and accurate.
________________________
Signature of principal
________________________
Date
D. A person who knowingly and intentionally makes a false statement of a material fact on the disclosure statement is guilty of a Class 5 felony.
E. Each lobbyist shall send to each legislative and executive official who is required to be identified by name on Schedule A or B of the Lobbyist's Disclosure Form a copy of Schedule A or B or a summary of the information pertaining to that official. Copies or summaries shall be provided to the official by November 21 for the preceding six-month period complete through the last day of October and by May 21 for the preceding six-month period complete through the last day of April.
§ 2.2-3114. Disclosure by state officers and employees.
A. The Governor, Lieutenant Governor, Attorney General,
Justices of the Supreme Court, judges of the Court of Appeals, judges of any
circuit court, judges and substitute judges of any district court, members of
the State Corporation Commission, members of the Virginia Workers' Compensation
Commission, members of the Commonwealth Transportation Board, members of the
Board of Trustees of the Virginia Retirement System, members of the Virginia
Alcoholic Beverage Control Board, and members of the Virginia Lottery Board and
other persons occupying such offices or positions of trust or employment in
state government, including members of the governing bodies of authorities, as
may be designated by the Governor, or officers or employees of the legislative
branch, as may be designated by the Joint Rules Committee of the General Assembly,
shall file with the Council, as a condition to assuming office or employment, a
disclosure statement of their personal interests and such other information as
is specified required
on the form set forth in prescribed by the
Council pursuant to § 2.2-3117 and thereafter shall file such a
statement semiannually by December 15 for the preceding six-month period
complete through the last day of October and by June 15 for the preceding
six-month period complete through the last day of April. When the filing
deadline falls on a Saturday, Sunday, or legal holiday, the disclosure
statement shall be filed on the next day that is not a Saturday, Sunday, or
legal holiday.
B. Nonsalaried citizen members of all policy and supervisory
boards, commissions and councils in the executive branch of state government,
other than the Commonwealth Transportation Board, members of the Board of
Trustees of the Virginia Retirement System, and the Virginia Lottery Board,
shall file with the Council, as a condition to assuming office, a disclosure
form of their personal interests and such other information as is
specified required on the form set
forth in prescribed by the Council pursuant to
§ 2.2-3118 and thereafter shall file such form annually on or before December
15. When the filing deadline falls on a Saturday, Sunday, or legal holiday, the
disclosure statement shall be filed on the next day that is not a Saturday,
Sunday, or legal holiday. Nonsalaried citizen members of other boards,
commissions and councils, including advisory boards and authorities, may be
required to file a disclosure form if so designated by the Governor, in which
case the form shall be that set forth in prescribed by the
Council pursuant to § 2.2-3118.
C. (Effective January 1, 2016, until July 1, 2016) The disclosure forms required by subsections A and B shall be made available by the Council at least 30 days prior to the filing deadline. Disclosure forms shall be filed and maintained as public records for five years in the office of the Council. Such forms shall be made public no later than six weeks after filing.
C. (Effective July 1, 2016) The disclosure forms required by subsections A and B shall be made available by the Council at least 30 days prior to the filing deadline. Disclosure forms shall be filed electronically with the Council in accordance with the standards approved by it pursuant to § 30-356. All forms shall be maintained as public records for five years in the office of the Council. Such forms shall be made public no later than six weeks after filing.
D. Candidates for the offices of Governor, Lieutenant Governor or Attorney General shall file a disclosure statement of their personal interests as required by § 24.2-502.
E. Any officer or employee of state government who has a personal interest in any transaction before the governmental or advisory agency of which he is an officer or employee and who is disqualified from participating in that transaction pursuant to subdivision A 1 of § 2.2-3112, or otherwise elects to disqualify himself, shall forthwith make disclosure of the existence of his interest, including the full name and address of the business and the address or parcel number for the real estate if the interest involves a business or real estate, and his disclosure shall also be reflected in the public records of the agency for five years in the office of the administrative head of the officer's or employee's governmental agency or advisory agency or, if the agency has a clerk, in the clerk's office.
F. An officer or employee of state government who is required to declare his interest pursuant to subdivision A 2 of § 2.2-3112, shall declare his interest by stating (i) the transaction involved, (ii) the nature of the officer's or employee's personal interest affected by the transaction, (iii) that he is a member of a business, profession, occupation, or group the members of which are affected by the transaction, and (iv) that he is able to participate in the transaction fairly, objectively, and in the public interest. The officer or employee shall either make his declaration orally to be recorded in written minutes for his agency or file a signed written declaration with the clerk or administrative head of his governmental or advisory agency, as appropriate, who shall, in either case, retain and make available for public inspection such declaration for a period of five years from the date of recording or receipt. If reasonable time is not available to comply with the provisions of this subsection prior to participation in the transaction, the officer or employee shall prepare and file the required declaration by the end of the next business day.
G. An officer or employee of state government who is required to declare his interest pursuant to subdivision A 3 of § 2.2-3112, shall declare his interest by stating (i) the transaction involved, (ii) that a party to the transaction is a client of his firm, (iii) that he does not personally represent or provide services to the client, and (iv) that he is able to participate in the transaction fairly, objectively, and in the public interest. The officer or employee shall either make his declaration orally to be recorded in written minutes for his agency or file a signed written declaration with the clerk or administrative head of his governmental or advisory agency, as appropriate, who shall, in either case, retain and make available for public inspection such declaration for a period of five years from the date of recording or receipt. If reasonable time is not available to comply with the provisions of this subsection prior to participation in the transaction, the officer or employee shall prepare and file the required declaration by the end of the next business day.
H. Notwithstanding any other provision of law, chairs of departments at a public institution of higher education in the Commonwealth shall not be required to file the disclosure form prescribed by the Council pursuant to § 2.2-3117 or 2.2-3118.
§ 2.2-3115. Disclosure by local government officers and employees.
A. The members of every governing body and school board of
each county and city and of towns with populations in excess of 3,500 shall
file, as a condition to assuming office or employment, a disclosure statement
of their personal interests and other information as is specified
required on the form set forth in
prescribed by the Council pursuant to § 2.2-3117 and thereafter
shall file such a statement semiannually by December 15 for the preceding
six-month period complete through the last day of October and by June 15 for
the preceding six-month period complete through the last day of April.
The members of the governing body of any authority established
in any county or city, or part or combination thereof, and having the power to
issue bonds or expend funds in excess of $10,000 in any fiscal year, shall
file, as a condition to assuming office, a disclosure statement of their
personal interests and other information as is specified
required on the form set forth in
prescribed by the Council pursuant to § 2.2-3118 and thereafter
shall file such a statement annually on or before December 15, unless the
governing body of the jurisdiction that appoints the members requires that the
members file the form set forth in prescribed by the
Council pursuant to § 2.2-3117 semiannually by December 15 for the
preceding six-month period complete through the last day of October and by June
15 for the preceding six-month period complete through the last day of April.
Persons occupying such positions of trust appointed by governing
bodies and persons occupying such positions of employment with governing bodies
as may be designated to file by ordinance of the governing body shall file, as
a condition to assuming office or employment, a disclosure statement of their
personal interests and other information as is specified
required on the form set forth in
prescribed by the Council in § 2.2-3117 and thereafter shall file
such a statement semiannually by December 15 for the preceding six-month period
complete through the last day of October and by June 15 for the preceding
six-month period complete through the last day of April.
Persons occupying such positions of trust appointed by school
boards and persons occupying such positions of employment with school boards as
may be designated to file by an adopted policy of the school board shall file,
as a condition to assuming office or employment, a disclosure statement of
their personal interests and other information as is specified
required on the form set forth in
prescribed by the Council pursuant to § 2.2-3117 and thereafter
shall file such a statement semiannually by December 15 for the preceding
six-month period complete through the last day of October and by June 15 for
the preceding six-month period complete through the last day of April.
B. Nonsalaried citizen members of local boards, commissions
and councils as may be designated by the governing body shall file, as a
condition to assuming office, a disclosure form of their personal interests and
such other information as is specified required
on the form set forth in prescribed by the
Council pursuant to § 2.2-3118 and thereafter shall file such form
annually on or before December 15.
C. No person shall be mandated to file any disclosure not otherwise required by this article.
D. The disclosure forms required by subsections A and B shall be made available by the Virginia Conflict of Interest and Ethics Advisory Council at least 30 days prior to the filing deadline, and the clerks of the governing body and school board shall distribute the forms to designated individuals at least 20 days prior to the filing deadline. Forms shall be filed and maintained as public records for five years in the office of the clerk of the respective governing body or school board. Forms filed by members of governing bodies of authorities shall be filed and maintained as public records for five years in the office of the clerk of the governing body of the county or city. Such forms shall be made public no later than six weeks after filing.
E. Candidates for membership in the governing body or school board of any county, city or town with a population of more than 3,500 persons shall file a disclosure statement of their personal interests as required by § 24.2-502.
F. Any officer or employee of local government who has a personal interest in any transaction before the governmental or advisory agency of which he is an officer or employee and who is disqualified from participating in that transaction pursuant to subdivision A 1 of § 2.2-3112 or otherwise elects to disqualify himself, shall forthwith make disclosure of the existence of his interest, including the full name and address of the business and the address or parcel number for the real estate if the interest involves a business or real estate, and his disclosure shall be reflected in the public records of the agency for five years in the office of the administrative head of the officer's or employee's governmental or advisory agency.
G. In addition to any disclosure required by subsections A and B, in each county and city and in towns with populations in excess of 3,500, members of planning commissions, boards of zoning appeals, real estate assessors, and all county, city and town managers or executive officers shall make annual disclosures of all their interests in real estate located in the county, city or town in which they are elected, appointed, or employed. Such disclosure shall include any business in which such persons own an interest, or from which income is received, if the primary purpose of the business is to own, develop or derive compensation through the sale, exchange or development of real estate in the county, city or town. Such disclosure shall be filed as a condition to assuming office or employment, and thereafter shall be filed annually with the clerk of the governing body of such county, city, or town on or before December 15. Such disclosures shall be filed and maintained as public records for five years. Such forms shall be made public no later than six weeks after filing. Forms for the filing of such reports shall be made available by the Virginia Conflict of Interest and Ethics Advisory Council to the clerk of each governing body.
H. An officer or employee of local government who is required to declare his interest pursuant to subdivision A 2 of § 2.2-3112 shall declare his interest by stating (i) the transaction involved, (ii) the nature of the officer's or employee's personal interest affected by the transaction, (iii) that he is a member of a business, profession, occupation, or group the members of which are affected by the transaction, and (iv) that he is able to participate in the transaction fairly, objectively, and in the public interest. The officer or employee shall either make his declaration orally to be recorded in written minutes for his agency or file a signed written declaration with the clerk or administrative head of his governmental or advisory agency, as appropriate, who shall, in either case, retain and make available for public inspection such declaration for a period of five years from the date of recording or receipt. If reasonable time is not available to comply with the provisions of this subsection prior to participation in the transaction, the officer or employee shall prepare and file the required declaration by the end of the next business day. The officer or employee shall also orally disclose the existence of the interest during each meeting of the governmental or advisory agency at which the transaction is discussed and such disclosure shall be recorded in the minutes of the meeting.
I. An officer or employee of local government who is required to declare his interest pursuant to subdivision A 3 of § 2.2-3112, shall declare his interest by stating (i) the transaction involved, (ii) that a party to the transaction is a client of his firm, (iii) that he does not personally represent or provide services to the client, and (iv) that he is able to participate in the transaction fairly, objectively, and in the public interest. The officer or employee shall either make his declaration orally to be recorded in written minutes for his agency or file a signed written declaration with the clerk or administrative head of his governmental or advisory agency, as appropriate, who shall, in either case, retain and make available for public inspection such declaration for a period of five years from the date of recording or receipt. If reasonable time is not available to comply with the provisions of this subsection prior to participation in the transaction, the officer or employee shall prepare and file the required declaration by the end of the next business day.
§ 2.2-3116. (Effective from January 1, 2016, until July 1, 2016) Disclosure by certain constitutional officers.
For the purposes of this chapter, holders of the
constitutional offices of treasurer, sheriff, attorney for the Commonwealth,
clerk of the circuit court, and commissioner of the revenue of each county and
city shall be required to file with the Council, as a condition to assuming
office, the Statement of Economic Interests set forth in
prescribed by the Council pursuant to § 2.2-3117. These officers
shall file statements semiannually by December 15 for the preceding six-month
period complete through the last day of October and by June 15 for the
preceding six-month period complete through the last day of April. Candidates
shall file statements as required by § 24.2-502. These officers shall be
subject to the prohibition on certain gifts set forth in subsection B of §
2.2-3103.1.
§ 2.2-3116. (Effective July 1, 2016) Disclosure by certain constitutional officers.
For the purposes of this chapter, holders of the
constitutional offices of treasurer, sheriff, attorney for the Commonwealth,
clerk of the circuit court, and commissioner of the revenue of each county and
city shall be required to file with the Council, as a condition to assuming
office, the Statement of Economic Interests set forth in
prescribed by the Council pursuant to § 2.2-3117. These officers
shall file statements semiannually by December 15 for the preceding six-month
period complete through the last day of October and by June 15 for the
preceding six-month period complete through the last day of April. Candidates
shall file statements as required by § 24.2-502. Statements shall be filed
electronically with the Council in accordance with the standards approved by it
pursuant to § 30-356. These officers shall be subject to the prohibition on
certain gifts set forth in subsection B of § 2.2-3103.1.
§ 2.2-3117. Disclosure form.
(Effective from January 1, 2016, until July 1, 2016) The
disclosure form to be used for filings required by subsections A and D of §
2.2-3114 and subsections A and E of § 2.2-3115 shall be substantially similar
to the following prescribed by the Council. Any person
who knowingly and intentionally makes a false statement of a material fact on
the Statement of Economic Interests is guilty of a Class 5 felony.
(Effective July 1, 2016) The disclosure form to be used for
filings required by subsections A and D of § 2.2-3114 and subsections A and E
of § 2.2-3115 shall be substantially similar to the following
prescribed by the Council. Except as otherwise provided in §
2.2-3115, all completed forms shall be filed electronically with the Council in
accordance with the standards approved by it pursuant to § 30-356. Any person
who knowingly and intentionally makes a false statement of a material fact on
the Statement of Economic Interests is guilty of a Class 5 felony.
STATEMENT OF ECONOMIC INTERESTS.
Name__________________________________________________________
Office or position held or
sought_____________________________________
Address________________________________________________________
Names of members of immediate
family________________________________
DEFINITIONS AND EXPLANATORY MATERIAL.
"Business" means a corporation,
partnership, sole proprietorship, firm, enterprise, franchise, association,
trust or foundation, or any other individual or entity carrying on a business
or profession, whether or not for profit.
"Close financial association" means an
association in which the person filing shares significant financial involvement
with an individual and the filer would reasonably be expected to be aware of
the individual's business activities and would have access to the necessary
records either directly or through the individual. "Close financial
association" does not mean an association based on (i) the receipt of
retirement benefits or deferred compensation from a business by which the
person filing this statement is no longer employed, or (ii) the receipt of
compensation for work performed by the person filing as an independent
contractor of a business that represents an entity before any state
governmental agency when the person filing has had no communications with the
state governmental agency.
"Contingent liability" means a liability
that is not presently fixed or determined, but may become fixed or determined
in the future with the occurrence of some certain event.
"Gift" means any gratuity, favor,
discount, entertainment, hospitality, loan, forbearance, or other item having
monetary value. It includes services as well as gifts of transportation,
lodgings and meals, whether provided in-kind, by purchase of a ticket, payment
in advance or reimbursement after the expense has been incurred.
"Gift" does not include (i) any offer of a ticket, coupon, or other
admission or pass unless the ticket, coupon, admission, or pass is used; (ii)
honorary degrees; (iii) any athletic, merit, or need-based scholarship or any
other financial aid awarded by a public or private school, institution of
higher education, or other educational program pursuant to such school,
institution, or program's financial aid standards and procedures applicable to
the general public; (iv) a campaign contribution properly received and reported
pursuant to Chapter 9.3 (§ 24.2-945 et seq.) of Title 24.2; (v) any gift
related to the private profession or occupation of an officer or employee or of
a member of his immediate family; (vi) food or beverages consumed while
attending an event at which the filer is performing official duties related to
his public service; (vii) food and beverages received at or registration or
attendance fees waived for any event at which the filer is a featured speaker,
presenter, or lecturer; (viii) unsolicited awards of appreciation or
recognition in the form of a plaque, trophy, wall memento, or similar item that
is given in recognition of public, civic, charitable, or professional service;
(ix) a devise or inheritance; (x) travel disclosed pursuant to the Campaign
Finance Disclosure Act (§ 24.2-945 et seq.); (xi) travel paid for or provided
by the government of the United States, any of its territories, or any state or
any political subdivision of such state; (xii) travel provided to facilitate
attendance by a legislator at a regular or special session of the General
Assembly, a meeting of a legislative committee or commission, or a national
conference where attendance is approved by the House or Senate Committee on
Rules; (xiii) travel related to an official meeting of the Commonwealth, its
political subdivisions, or any board, commission, authority, or other entity,
or any charitable organization established pursuant to § 501(c)(3) of the
Internal Revenue Code affiliated with such entity, to which such person has
been appointed or elected or is a member by virtue of his office or employment;
or (xiv) gifts from relatives or personal friends. "Relative" means
the donee's spouse, child, uncle, aunt, niece, nephew, or first cousin; a person
to whom the donee is engaged to be married; the donee's or his spouse's parent,
grandparent, grandchild, brother, sister, step-parent, step-grandparent,
step-grandchild, step-brother, or step-sister; or the donee's brother's or
sister's spouse. "Personal friend" does not include any person that
the filer knows or has reason to know is (a) a lobbyist registered pursuant to
Article 3 (§ 2.2-418 et seq.) of Chapter 4 of Title 2.2; (b) a lobbyist's
principal as defined in § 2.2-419; (c) for an officer or employee of a local
governmental or advisory agency, a person, organization, or business who is a
party to or is seeking to become a party to a contract with the local agency of
which he is an officer or an employee; or (d) for an officer or employee of a state
governmental or advisory agency, a person, organization, or business who is a
party to or is seeking to become a party to a contract with the Commonwealth.
"Person, organization, or business" includes individuals who are
officers, directors, or owners of or who have a controlling ownership interest
in such organization or business.
"Immediate family" means (i) a spouse and
(ii) any other person who resides in the same household as the officer or
employee and who is a dependent of the officer or employee.
TRUST. If you or your immediate family, separately
or together, are the only beneficiaries of a trust, treat the trust's assets as
if you own them directly. If you or your immediate family has a proportional
interest in a trust, treat that proportion of the trust's assets as if you own
them directly. For example, if you and your immediate family have a one-third
interest in a trust, complete your Statement as if you own one-third of each of
the trust's assets. If you or a member of your immediate family created a trust
and can revoke it without the beneficiaries' consent, treat its assets as if
you own them directly.
REPORT TO THE BEST OF INFORMATION AND BELIEF.
Information required on this Statement must be provided on the basis of the
best knowledge, information, and belief of the individual filing the Statement
as of the date of this report unless otherwise stated.
COMPLETE ITEMS 1 THROUGH 10. REFER TO SCHEDULES
ONLY IF DIRECTED.
You may attach additional explanatory information.
1. Offices and Directorships.
Are you or a member of your immediate family a paid
officer or paid director of a business?
EITHER check NO / / OR check YES / / and complete
Schedule A.
2. Personal Liabilities.
Do you or a member of your immediate family owe
more than $5,000 to any one creditor including contingent liabilities? (Exclude
debts to any government and loans secured by recorded liens on property at
least equal in value to the loan.)
EITHER check NO / / OR check YES / / and complete
Schedule B.
3. Securities.
Do you or a member of your immediate family,
directly or indirectly, separately or together, own securities valued in excess
of $5,000 invested in one business? Account for mutual funds, limited
partnerships and trusts.
EITHER check NO / / OR check YES / / and complete
Schedule C.
4. Payments for Talks, Meetings, and Publications.
During the past six months did you receive in your
capacity as an officer or employee of your agency lodging, transportation,
money, or anything else of value with a combined value exceeding $100 (i) for a
single talk, meeting, or published work or (ii) for a meeting, conference, or
event where your attendance at the meeting, conference, or event was designed
to (a) educate you on issues relevant to your duties as an officer or employee
of your agency or (b) enhance your knowledge and skills relative to your duties
as an officer or employee of your agency?
EITHER check NO / / OR check YES / / and complete
Schedule D.
5. Gifts.
During the past six months did a business,
government, or individual other than a relative or personal friend (i) furnish
you or a member of your immediate family with any gift or entertainment at a
single event and the value received exceeded $50 or (ii) furnish you or a
member of your immediate family with gifts or entertainment in any combination
and the total value received exceeded $50, and for which you or the member of
your immediate family neither paid nor rendered services in exchange? Account
for entertainment events only if the average value per person attending the
event exceeded $50. Account for all business entertainment (except if related
to the private profession or occupation of you or the member of your immediate
family who received such business entertainment) even if unrelated to your
official duties.
EITHER check NO / / OR check YES / / and complete
Schedule E.
6. Salary and Wages.
List each employer that pays you or a member of
your immediate family salary or wages in excess of $5,000 annually. (Exclude
state or local government or advisory agencies.)
If no reportable salary or wages, check here / /.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
7. Business Interests.
Do you or a member of your immediate family,
separately or together, operate your own business, or own or control an
interest in excess of $5,000 in a business?
EITHER check NO / / OR check YES / / and complete
Schedule F.
8. Payments for Representation and Other Services.
8A. Did you represent, excluding activity defined
as lobbying in § 2.2-419, any businesses before any state governmental
agencies, excluding courts or judges, for which you received total compensation
during the past six months in excess of $1,000, excluding compensation for
other services to such businesses and representation consisting solely of the
filing of mandatory papers and subsequent representation regarding the
mandatory papers? (Officers and employees of local governmental and advisory
agencies do NOT need to answer this question or complete Schedule G-1.)
EITHER check NO / / OR check YES / / and complete
Schedule G-1.
8B. Subject to the same exceptions as in 8A, did
persons with whom you have a close financial association (partners, associates
or others) represent, excluding activity defined as lobbying in § 2.2-419, any
businesses before any state governmental agency for which total compensation
was received during the past six months in excess of $1,000? (Officers and
employees of local governmental and advisory agencies do NOT need to answer
this question or complete Schedule G-2.)
EITHER check NO / / OR check YES / / and complete
Schedule G-2.
8C. Did you or persons with whom you have a close
financial association furnish services to businesses operating in Virginia
pursuant to an agreement between you and such businesses, or between persons
with whom you have a close financial association and such businesses for which
total compensation in excess of $1,000 was received during the past six months?
Services reported under this provision shall not include services involving the
representation of businesses that are reported under item 8A or 8B.
EITHER check NO / / OR check YES / / and complete
Schedule G-3.
9. Real Estate.
9A. State Officers and Employees.
Do you or a member of your immediate family hold an
interest, including a partnership interest, valued at more than $5,000 in real
property (other than your principal residence) for which you have not already
listed the full address on Schedule F? Account for real estate held in trust.
EITHER check NO / / OR check YES / / and complete
Schedule H-1.
9B. Local Officers and Employees.
Do you or a member of your immediate family hold an
interest, including a partnership interest, or option, easement, or land
contract, valued at more than $5,000 in real property (other than your
principal residence) for which you have not already listed the full address on
Schedule F? Account for real estate held in trust.
EITHER check NO / / OR check YES / / and complete
Schedule H-2.
10. Real Estate Contracts with Governmental
Agencies.
Do you or a member of your immediate family hold an
interest valued at more than $5,000 in real estate, including a corporate,
partnership, or trust interest, option, easement, or land contract, which real
estate is the subject of a contract, whether pending or completed within the
past six months, with a governmental agency? If the real estate contract
provides for the leasing of the property to a governmental agency, do you or a
member of your immediate family hold an interest in the real estate valued at
more than $1,000? Account for all such contracts whether or not your interest
is reported in Schedule F, H-1, or H-2. This requirement to disclose an
interest in a lease does not apply to an interest derived through an ownership
interest in a business unless the ownership interest exceeds three percent of
the total equity of the business.
EITHER check NO / / OR check YES / / and complete
Schedule I.
Statements of Economic Interests are open for
public inspection.
AFFIRMATION BY ALL FILERS.
I swear or affirm that the foregoing information is
full, true and correct to the best of my knowledge.
Signature________________________________
(Return only if needed to complete Statement.)
SCHEDULES to STATEMENT OF ECONOMIC INTERESTS.
NAME__________________________________
SCHEDULE A -- OFFICES AND DIRECTORSHIPS.
Identify each business of which you or a member of
your immediate family is a paid officer or paid director.
_______________________________________________________________________
Name of Business Address of Business Position Held and by Whom
___________________ _____________________ _________________________
___________________ _____________________ _________________________
___________________ _____________________ _________________________
___________________ _____________________ _________________________
_______________________________________________________________________
RETURN TO ITEM 2
SCHEDULE B -- PERSONAL LIABILITIES.
Report personal liability by checking each
category. Report only debts in excess of $5,000. Do not report debts to any
government. Do not report loans secured by recorded liens on property at least
equal in value to the loan.
Report contingent liabilities below and indicate
which debts are contingent.
1. My personal debts are as follows:
_______________________________________________________________________
Check Check one
appropriate $5,001 to More than
categories $50,000 $50,000
Banks __________ _________
Savings institutions __________ _________
Other loan or finance companies __________ _________
Insurance companies __________ _________
Stock, commodity or other brokerage companies __________ _________
Other businesses:
(State principal business activity for each
creditor and its name.)
_________________________________________ __________ _________
_________________________________________ __________ _________
Individual creditors:
(State principal business or occupation of
each creditor and its name.)
_________________________________________ __________ _________
_________________________________________ __________ _________
_______________________________________________________________________
2. The personal debts of the members of my
immediate family are as follows:
_______________________________________________________________________
Check Check one
appropriate $5,001 to More than
categories $50,000 $50,000
Banks __________ _________
Savings institutions __________ _________
Other loan or finance companies __________ _________
Insurance companies __________ _________
Stock, commodity or other brokerage companies __________ _________
Other businesses:
(State principal business activity for each
creditor and its name.)
_________________________________________ __________ _________
_________________________________________ __________ _________
Individual creditors:
(State principal business or occupation of
each creditor and its name.)
_________________________________________ __________ _________
_________________________________________ __________ _________
_______________________________________________________________________
RETURN TO ITEM 3
SCHEDULE C -- SECURITIES.
"Securities" INCLUDES stocks, bonds,
mutual funds, limited partnerships, and commodity futures contracts.
"Securities" EXCLUDES certificates of
deposit, money market funds, annuity contracts, and insurance policies.
Identify each business or Virginia governmental
entity in which you or a member of your immediate family, directly or
indirectly, separately or together, own securities valued in excess of $5,000.
Name each issuer and type of security individually.
Do not list U.S. Bonds or other government securities
not issued by the Commonwealth of Virginia or its authorities, agencies, or
local governments. Do not list organizations that do not do business in this
Commonwealth, but most major businesses conduct business in Virginia. Account
for securities held in trust.
If no reportable securities, check here / /.
____________________________________________________________________________
Check one
Type of Security $5,001 $50,001 More
(stocks, bonds, mutual to to than
Name of Issuer funds, etc.) $50,000 $250,000 $250,000
________________________ _______________________ _______ _______ ________
________________________ _______________________ _______ _______ ________
________________________ _______________________ _______ _______ ________
________________________ _______________________ _______ _______ ________
____________________________________________________________________________
RETURN TO ITEM 4
SCHEDULE D -- PAYMENTS FOR TALKS, MEETINGS, AND
PUBLICATIONS.
List each source from which you received during the
past six months in your capacity as an officer or employee of your agency
lodging, transportation, money, or any other thing of value with combined value
exceeding $100 (i) for your presentation of a single talk, participation in one
meeting, or publication of a work or (ii) for your attendance at a meeting,
conference, or event where your attendance at the meeting, conference, or event
was designed to (a) educate you on issues relevant to your duties as an officer
or employee of your agency or (b) enhance your knowledge and skills relative to
your duties as an officer or employee of your agency. Any lodging,
transportation, money, or other thing of value received by an officer or
employee that does not satisfy the provisions of clause (i), (ii) (a), or (ii)
(b) shall be listed as a gift on Schedule E.
List payments or reimbursements by an advisory or
governmental agency only for meetings or travel outside the Commonwealth.
List a payment even if you donated it to charity.
Do not list information about a payment if you
returned it within 60 days or if you received it from an employer already
listed under Item 6 or from a source of income listed on Schedule F.
If no payment must be listed, check here / /.
________________________________________________________________________
Type of payment
(e.g., honoraria,
travel reimburse-
Payer Approximate Value Circumstances ment, etc.)
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________________________________________________________________
RETURN TO ITEM 5
SCHEDULE E -- GIFTS.
List each business, governmental entity, or
individual that, during the past six months, (i) furnished you or a member of
your immediate family with any gift or entertainment at a single event, and the
value received exceeded $50 or (ii) furnished you or a member of your immediate
family with gifts or entertainment in any combination and the total value
received exceeded $50, and for which you or the member of your immediate family
neither paid nor rendered services in exchange. List each such gift or event.
Do not list entertainment events unless the average value per person attending
the event exceeded $50. Do not list business entertainment related to the
private profession or occupation of you or the member of your immediate family
who received such business entertainment. Do not list gifts or other things of
value given by a relative or personal friend for reasons clearly unrelated to
your public position. Do not list campaign contributions publicly reported as
required by Chapter 9.3 (§ 24.2-945 et seq.) of Title 24.2 of the Code of
Virginia.
_________________________________________________________________________
Name of Business, City or Exact
Name of Organization, or County Gift or Approximate
Recipient Individual and State Event Value
___________ __________________ __________ ___________ ___________
___________ __________________ __________ ___________ ___________
___________ __________________ __________ ___________ ___________
___________ __________________ __________ ___________ ___________
________________________________________________ ________________________
RETURN TO ITEM 6
SCHEDULE F -- BUSINESS INTERESTS.
Complete this Schedule for each self-owned or
family-owned business (including rental property, a farm, or consulting work),
partnership, or corporation in which you or a member of your immediate family,
separately or together, own an interest having a value in excess of $5,000.
If the enterprise is owned or operated under a
trade, partnership, or corporate name, list that name; otherwise, merely
explain the nature of the enterprise. If rental property is owned or operated
under a trade, partnership, or corporate name, list the name only; otherwise,
give the address of each property. Account for business interests held in
trust.
___________________________________________________________________________
Name of Business, Gross Income
Corporation,
Partnership, City or Nature of Enterprise $50,001 More
Farm; Address of County (farming, law, rental $50,000 to than
Rental Property and State property, etc.) or less $250,000 $250,000
________________ _________ _____________________ ________ ________ ________
________________ _________ _____________________ ________ ________ ________
________________ _________ _____________________ ________ ________ ________
________________ _________ _____________________ ________ ________ ________
___________________________________________________________________________
RETURN TO ITEM 8
SCHEDULE G-1 -- PAYMENTS FOR REPRESENTATION BY YOU.
List the businesses you represented, excluding
activity defined as lobbying in § 2.2-419, before any state governmental
agency, excluding any court or judge, for which you received total compensation
during the past six months in excess of $1,000, excluding compensation for
other services to such businesses and representation consisting solely of the
filing of mandatory papers and subsequent representation regarding the
mandatory papers filed by you.
Identify each business, the nature of the
representation and the amount received by dollar category from each such
business. You may state the type, rather than name, of the business if you are
required by law not to reveal the name of the business represented by you.
Only STATE officers and employees should complete this
Schedule.
_____________________________________________________________________
Pur- Amount Received
pose
Name Type of Name
of of Repre- of $1,001 $10,001 $50,001 $100,001 $250,001
Busi- Busi- senta- Agen- to to to to and
ness ness tion cy $10,000 $50,000 $100,000 $250,000 over
_____ _____ ______ ______ _______ _______ ________ _________ ________
_____ _____ ______ ______ _______ _______ ________ _________ ________
_____ _____ ______ ______ _______ _______ ________ _________ ________
_____ _____ ______ ______ _______ _______ ________ _________ ________
_____________________________________________________________________
If you have received $250,001 or more from a single
business within the reporting period, indicate the amount received, rounded to
the nearest $10,000.
Amount Received: _______________________.
SCHEDULE G-2 -- PAYMENTS FOR REPRESENTATION BY
ASSOCIATES.
List the businesses that have been represented, excluding activity defined as
lobbying in § 2.2-419, before any state governmental agency, excluding any
court or judge, by persons who are your partners, associates or others with
whom you have a close financial association and who received total compensation
in excess of $1,000 for such representation during the past six months,
excluding representation consisting solely of the filing of mandatory papers
and subsequent representation regarding the mandatory papers filed by your
partners, associates or others with whom you have a close financial
association.
Identify such businesses by type and also name the
state governmental agencies before which such person appeared on behalf of such
businesses.
Only STATE officers and employees should complete
this Schedule.
______________________________________________________________
Type of business Name of state governmental agency
____________________ ______________________________________
____________________ ______________________________________
____________________ ______________________________________
____________________ ______________________________________
______________________________________________________________
SCHEDULE G-3 -- PAYMENTS FOR OTHER SERVICES
GENERALLY.
Indicate below types of businesses that operate in
Virginia to which services were furnished by you or persons with whom you have
a close financial association pursuant to an agreement between you and such
businesses, or between persons with whom you have a close financial association
and such businesses and for which total compensation in excess of $1,000 was
received during the past six months. Services reported in this Schedule shall
not include services involving the representation of businesses that are
reported in Schedule G-1 or G-2.
Identify opposite each category of businesses
listed below (i) the type of business, (ii) the type of service rendered and
(iii) the value by dollar category of the compensation received for all
businesses falling within each category.
___________________________________________________________________________
Check Value of Compensation
if Type
ser- of
vices ser-
were vice $1,001 $10,001 $50,001 $100,001 $250,001
ren- ren- to to to to and
dered dered $10,000 $50,000 $100,000 $250,000 over
Electric utilities _____ _____ _______ _______ ________ ________ ________
Gas utilities _____ _____ _______ _______ ________ ________ ________
Telephone utilities _____ _____ _______ _______ ________ ________ ________
Water utilities _____ _____ _______ _______ ________ ________ ________
Cable television
companies _____ _____ _______ _______ ________ ________ ________
Interstate
transportation
companies _____ _____ _______ _______ ________ ________ ________
Intrastate
transportation
companies _____ _____ _______ _______ ________ ________ ________
Oil or gas retail
companies _____ _____ _______ _______ ________ ________ ________
Banks _____ _____ _______ _______ ________ ________ ________
Savings institutions _____ _____ _______ _______ ________ ________ ________
Loan or finance
companies _____ _____ _______ _______ ________ ________ ________
Manufacturing
companies (state
type of product,
e.g., textile,
furniture, etc.) _____ _____ _______ _______ ________ ________ ________
Mining companies _____ _____ _______ _______ ________ ________ ________
Life insurance
companies _____ _____ _______ _______ ________ ________ ________
Casualty insurance
companies _____ _____ _______ _______ ________ ________ ________
Other insurance
companies _____ _____ _______ _______ ________ ________ ________
Retail companies _____ _____ _______ _______ ________ ________ ________
Beer, wine or liquor
companies or
distributors _____ _____ _______ _______ ________ ________ ________
Trade associations _____ _____ _______ _______ ________ ________ ________
Professional
associations _____ _____ _______ _______ ________ ________ ________
Associations of
public employees
or officials _____ _____ _______ _______ ________ ________ ________
Counties, cities
or towns _____ _____ _______ _______ ________ ________ ________
Labor organizations _____ _____ _______ _______ ________ ________ ________
Other _____ _____ _______ _______ ________ ________ ________
___________________________________________________________________________
RETURN TO ITEM 9
SCHEDULE H-1 -- REAL ESTATE -- STATE OFFICERS AND
EMPLOYEES.
List real estate other than your principal
residence in which you or a member of your immediate family holds an interest,
including a partnership interest, option, easement, or land contract, valued at
more than $5,000. Each parcel shall be listed individually.
_________________________________________________________________________
Describe the type of real
List each location estate you own in each If the real estate is
(state, and county location (business, recre- owned or recorded in
or city) where you ational, apartment, com- a name other than your
own real estate. mercial, open land, etc.). own, list that name.
_____________________ __________________________ ______________________
_____________________ __________________________ ______________________
_____________________ __________________________ ______________________
_____________________ __________________________ ______________________
_____________________ __________________________ ______________________
_________________________________________________________________________
SCHEDULE H-2 -- REAL ESTATE -- LOCAL OFFICERS AND
EMPLOYEES.
List real estate other than your principal
residence in which you or a member of your immediate family holds an interest,
including a partnership interest or option, easement, or land contract, valued
at more than $5,000. Each parcel shall be listed individually. Also list the
names of any co-owners of such property, if applicable.
_________________________________________________________________________
Describe the type
of real estate
you own in
each location If the real estate
List each location (business, is owned or rec-
(state, and county recreational, orded in a name
or city) where apartment, com- other than your List the names
you own real mercial, open own, list that of any co-owners,
estate. land, etc.). name. if applicable.
__________________ _________________ __________________ _________________
__________________ _________________ __________________ _________________
__________________ _________________ __________________ _________________
__________________ _________________ __________________ _________________
__________________ _________________ __________________ _________________
_________________________________________________________________________
SCHEDULE I -- REAL ESTATE CONTRACTS WITH
GOVERNMENTAL AGENCIES.
List all contracts, whether pending or completed
within the past six months, with a governmental agency for the sale or exchange
of real estate in which you or a member of your immediate family holds an
interest, including a corporate, partnership or trust interest, option,
easement, or land contract, valued at more than $10,000. List all contracts
with a governmental agency for the lease of real estate in which you or a member
of your immediate family holds such an interest valued at more than $1,000.
This requirement to disclose an interest in a lease does not apply to an
interest derived through an ownership interest in a business unless the
ownership interest exceeds three percent of the total equity of the business.
State officers and employees report contracts with
state agencies.
Local officers and employees report contracts with
local agencies.
_______________________________________________________________________
List your real estate
interest and the
person or entity,
including the type
of entity, which
is party to
the contract. State the annual
Describe any income from the
management role and List each governmental contract, and the
the percentage agency which is a amount, if any, of
ownership party to the contract income you or any
interest you or your and indicate the immediate family
immediate family county or city where member derives
member has in the real the real estate annually from the
estate or entity. is located. contract.
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
_______________________________________________________________________
§ 2.2-3118. Disclosure form; certain citizen members.
A. (Effective from January 1, 2016, until July 1, 2016) The
financial disclosure form to be used for filings required pursuant to
subsection B of § 2.2-3114 and subsection B of § 2.2-3115 shall be filed in
accordance with the provisions of § 30-356. The financial disclosure form shall
be substantially as follows:
prescribed by the Council.
A. (Effective
July 1, 2016) The financial disclosure form to be used for filings required
pursuant to subsection B of § 2.2-3114 and subsection B of § 2.2-3115 shall be
filed in accordance with the provisions of § 30-356. The financial disclosure
form shall be substantially similar to the following
prescribed by the Council. Except as otherwise provided in §
2.2-3115, all completed forms shall be filed electronically with the Council in
accordance with the standards approved by it pursuant to § 30-356.
DEFINITIONS AND EXPLANATORY MATERIAL.
"Business" means a corporation,
partnership, sole proprietorship, firm, enterprise, franchise, association,
trust or foundation, or any other individual or entity carrying on a business
or profession, whether or not for profit.
"Close financial association" means an
association in which the person filing shares significant financial involvement
with an individual and the filer would reasonably be expected to be aware of
the individual's business activities and would have access to the necessary
records either directly or through the individual.
"Close financial association" does not
mean an association based on (i) the receipt of retirement benefits or deferred
compensation from a business by which the person filing this statement is no
longer employed, or (ii) the receipt of compensation for work performed by the
person filing as an independent contractor of a business that represents an
entity before any state governmental agency when the person filing has no
communications with the state governmental agency.
"Contingent liability" means a liability
that is not presently fixed or determined, but may become fixed or determined
in the future with the occurrence of some certain event.
"Immediate family" means (i) a spouse and
(ii) any other person who resides in the same household as the filer and who is
a dependent of the filer.
"Personal interest" means, for the
purposes of this form only, a personal and financial benefit or liability
accruing to a filer or a member of his immediate family. Such interest shall
exist by reason of (i) ownership in real or personal property, tangible or
intangible; (ii) ownership in a business; (iii) income from a business; or (iv)
personal liability on behalf of a business; however, unless the ownership
interest in a business exceeds three percent of the total equity of the
business, or the liability on behalf of a business exceeds three percent of the
total assets of the business, or the annual income, and/or property or use of
such property, from the business exceeds $10,000 or may reasonably be
anticipated to exceed $10,000, such interest shall not constitute a
"personal interest."
Name___________________________________________________________
Office or position held or to be held
_______________________________________________________________
Address_________________________________________________________
I. FINANCIAL INTERESTS
My personal interests and those of my immediate
family are as follows:
Include all forms of personal interests held at the
time of filing: real estate, stocks, bonds, equity interests in proprietorships
and partnerships. You may exclude:
1. Deposits and interest bearing accounts in banks,
savings institutions and other institutions accepting such deposits or
accounts;
2. Interests in any business, other than a news
medium, representing less than three percent of the total equity value of the
business;
3. Liability on behalf of any business representing
less than three percent of the total assets of such business; and
4. Income (other than from salary) less than
$10,000 annually from any business. You need not state the value of any
interest. You must state the name or principal business activity of each
business in which you have a personal interest.
A. My personal interests are:
1. Residence, address, or, if no address, location
______________________________________________________________
2. Other real estate, address, or, if no address,
location
______________________________________________________________
3. Name or principal business activity of each
business in which stock, bond or equity interest is held
______________________________________________________________
B. The personal interests of my immediate family
are:
1. Real estate, address or, if no address, location
______________________________________________________________
2. Name or principal business activity of each
business in which stock, bond or equity interest is held
______________________________________________________________
II. OFFICES, DIRECTORSHIPS AND SALARIED EMPLOYMENTS
The paid offices, paid directorships and salaried
employments which I hold or which members of my immediate family hold and the
businesses from which I or members of my immediate family receive retirement
benefits are as follows:
(You need not state any dollar amounts.)
A. My paid offices, paid directorships and salaried
employments are:
_____________________________________________________________________
Position held Name of business
_______________________________ __________________________________
_______________________________ __________________________________
_______________________________ __________________________________
_____________________________________________________________________
B. The paid offices, paid directorships and
salaried employments of members of my immediate family are:
_____________________________________________________________________
Position held Name of business
_______________________________ __________________________________
_______________________________ __________________________________
_______________________________ __________________________________
_____________________________________________________________________
III. BUSINESSES TO WHICH SERVICES WERE FURNISHED
A. The businesses I have represented, excluding
activity defined as lobbying in § 2.2-419, before any state governmental
agency, excluding any court or judge, for which I have received total
compensation in excess of $1,000 during the preceding year, excluding
compensation for other services to such businesses and representation
consisting solely of the filing of mandatory papers, are as follows:
Identify businesses by name and name the state
governmental agencies before which you appeared on behalf of such businesses.
_____________________________________________________________________
Name of business Name of governmental agency
_____________________________ _________________________________
_____________________________ _________________________________
_____________________________ _________________________________
_____________________________________________________________________
B. The businesses that, to my knowledge, have been
represented, excluding activity defined as lobbying in § 2.2-419, before any
state governmental agency, excluding any court or judge, by persons with whom I
have a close financial association and who received total compensation in
excess of $1,000 during the preceding year, excluding compensation for other
services to such businesses and representation consisting solely of the filing
of mandatory papers, are as follows:
Identify businesses by type and name the state
governmental agencies before which such person appeared on behalf of such
businesses.
_____________________________________________________________________
Type of business Name of state governmental agency
______________________________ ___________________________________
______________________________ ___________________________________
______________________________ ___________________________________
_____________________________________________________________________
C. All other businesses listed below that operate
in Virginia to which services were furnished pursuant to an agreement between
you and such businesses and for which total compensation in excess of $1,000
was received during the preceding year:
Check each category of business to which services
were furnished.
_____________________________________________________
Electric utilities __________
Gas utilities __________
Telephone utilities __________
Water utilities __________
Cable television companies __________
Intrastate transportation companies __________
Interstate transportation companies __________
Oil or gas retail companies __________
Banks __________
Savings institutions __________
Loan or finance companies __________
Manufacturing companies (state type
of product, e.g., textile, furniture,
etc.) __________
Mining companies __________
Life insurance companies __________
Casualty insurance companies __________
Other insurance companies __________
Retail companies __________
Beer, wine or liquor companies or
distributors __________
Trade associations __________
Professional associations __________
Associations of public employees or
officials __________
Counties, cities or towns __________
Labor organizations __________
_____________________________________________________
IV. COMPENSATION FOR EXPENSES
The persons, associations, or other sources other
than my governmental agency from which I or a member of my immediate family
received remuneration in excess of $100 during the preceding year, in cash or
otherwise, as honorariums or payment of expenses in connection with my
attendance at any meeting or other function to which I was invited in my
official capacity are as follows:
_______________________________________________________________________
Description Amount of remuneration
Name of Source of occasion for each occasion
_____________________ ______________________ ______________________
_____________________ ______________________ ______________________
_____________________ ______________________ ______________________
_______________________________________________________________________
B. The
provisions of Part III A and B of the disclosure form prescribed by this
section shall not be applicable to officers and employees of local governmental
and local advisory agencies.
C. Except for real estate located within the
county, city or town in which the officer or employee serves or a county, city
or town contiguous to the county, city or town in which the officer or employee
serves, officers and employees of local governmental or advisory agencies shall
not be required to disclose under Part I of the form any other interests in
real estate.
§ 30-110. Disclosure.
A. (Effective January 1, 2016, through July 1, 2016) Every
legislator and legislator-elect shall file, as a condition to assuming office,
a disclosure statement of his personal interests and such other information as
is specified required
on the form set forth in prescribed by the
Council pursuant to § 30-111 and thereafter shall file such a
statement semiannually by December 15 for the preceding six-month period
complete through the last day of October and by June 15 for the preceding
six-month period complete through the last day of April. When the filing
deadline falls on a Saturday, Sunday, or legal holiday, the disclosure statement
shall be filed on the next day that is not a Saturday, Sunday, or legal
holiday. Disclosure forms shall be made available by the Virginia Conflict of
Interest and Ethics Advisory Council at least 30 days prior to the filing
deadline. Members of the Senate and members of the House of Delegates shall
file their disclosure forms with the Virginia Conflict of Interest and Ethics
Advisory Council. The disclosure forms of the members of the General Assembly
shall be maintained as public records for five years in the office of the
Virginia Conflict of Interest and Ethics Advisory Council. Such forms shall be
made public no later than six weeks after filing.
A. (Effective July 1, 2016) Every legislator and
legislator-elect shall file, as a condition to assuming office, a disclosure
statement of his personal interests and such other information as is
specified required on the form set
forth in prescribed by the Council pursuant
to § 30-111 and thereafter shall file such a statement
semiannually by December 15 for the preceding six-month period complete through
the last day of October and by June 15 for the preceding six-month period
complete through the last day of April. When the filing deadline falls on a
Saturday, Sunday, or legal holiday, the disclosure statement shall be filed on
the next day that is not a Saturday, Sunday, or legal holiday. Disclosure forms
shall be made available by the Virginia Conflict of Interest and Ethics
Advisory Council at least 30 days prior to the filing deadline. Disclosure
forms shall be filed electronically with the Virginia Conflict of Interest and
Ethics Advisory Council in accordance with the standards approved by it
pursuant to § 30-356. The disclosure forms of the members of the General
Assembly shall be maintained as public records for five years in the office of
the Virginia Conflict of Interest and Ethics Advisory Council. Such forms shall
be made public no later than six weeks after filing.
B. Candidates for the General Assembly shall file a disclosure statement of their personal interests as required by §§ 24.2-500 through 24.2-503.
C. Any legislator who has a personal interest in any transaction pending before the General Assembly and who is disqualified from participating in that transaction pursuant to § 30-108 and the rules of his house shall disclose his interest in accordance with the applicable rule of his house.
§ 30-111. Disclosure form.
A. (Effective from January 1, 2016, until July 1, 2016) The
disclosure form to be used for filings required by subsections A and B of §
30-110 shall be substantially similar to the following
prescribed by the Council.
A. (Effective July 1, 2016) The disclosure form to be used for
filings required by subsections A and B of § 30-110 shall be substantially similar
to the following prescribed by the Council. All
completed forms shall be filed electronically with the Council in accordance
with the standards approved by it pursuant to § 30-356.
STATEMENT OF ECONOMIC INTERESTS.
Name__________________________________________________________
Office or position held or
sought_____________________________________
Address________________________________________________________
Names of members of immediate
family________________________________
DEFINITIONS AND EXPLANATORY MATERIAL.
"Business" means a corporation,
partnership, sole proprietorship, firm, enterprise, franchise, association,
trust or foundation, or any other individual or entity carrying on a business
or profession, whether or not for profit.
"Close financial association" means an association
in which the filer shares significant financial involvement with an individual
and the filer would reasonably be expected to be aware of the individual's
business activities and would have access to the necessary records either
directly or through the individual. "Close financial association"
does not mean an association based on (i) the receipt of retirement benefits or
deferred compensation from a business by which the legislator is no longer
employed, or (ii) the receipt of compensation for work performed by the
legislator as an independent contractor of a business that represents an entity
before any state governmental agency when the legislator has had no
communications with the state governmental agency.
"Contingent liability" means a liability
that is not presently fixed or determined, but may become fixed or determined
in the future with the occurrence of some certain event.
"Gift" means any gratuity, favor,
discount, entertainment, hospitality, loan, forbearance, or other item having
monetary value. It includes services as well as gifts of transportation,
lodgings and meals, whether provided in-kind, by purchase of a ticket, payment
in advance or reimbursement after the expense has been incurred.
"Gift" does not include (i) any offer of a ticket, coupon, or other
admission or pass unless the ticket, coupon, admission, or pass is used; (ii)
honorary degrees; (iii) any athletic, merit, or need-based scholarship or any
other financial aid awarded by a public or private school, institution of higher
education, or other educational program pursuant to such school, institution,
or program's financial aid standards and procedures applicable to the general
public; (iv) a campaign contribution properly received and reported pursuant to
Chapter 9.3 (§ 24.2-945 et seq.) of Title 24.2; (v) any gift related to the
private profession or occupation of a legislator or of a member of his
immediate family; (vi) food or beverages consumed while attending an event at
which the filer is performing official duties related to his public service;
(vii) food and beverages received at or registration or attendance fees waived
for any event at which the filer is a featured speaker, presenter, or lecturer;
(viii) unsolicited awards of appreciation or recognition in the form of a
plaque, trophy, wall memento, or similar item that is given in recognition of
public, civic, charitable, or professional service; (ix) a devise or
inheritance; (x) travel disclosed pursuant to the Campaign Finance Disclosure
Act (§ 24.2-945 et seq.); (xi) travel paid for or provided by the government of
the United States, any of its territories, or any state or any political
subdivision of such state; (xii) travel provided to facilitate attendance by a
legislator at a regular or special session of the General Assembly, a meeting
of a legislative committee or commission, or a national conference where
attendance is approved by the House or Senate Committee on Rules; (xiii) travel
related to an official meeting of the Commonwealth, its political subdivisions,
or any board, commission, authority, or other entity, or any charitable
organization established pursuant to § 501(c)(3) of the Internal Revenue Code
affiliated with such entity, to which such person has been appointed or elected
or is a member by virtue of his office or employment; or (xiv) gifts from
relatives or personal friends. "Relative" means the donee's spouse,
child, uncle, aunt, niece, nephew, or first cousin; a person to whom the donee
is engaged to be married; the donee's or his spouse's parent, grandparent,
grandchild, brother, sister, step-parent, step-grandparent, step-grandchild,
step-brother, or step-sister; or the donee's brother's or sister's spouse.
"Personal friend" does not include any person that the filer knows or
has reason to know is (a) a lobbyist registered pursuant to Article 3 (§
2.2-418 et seq.) of Chapter 4 of Title 2.2 or (b) a lobbyist's principal as
defined in § 2.2-419.
"Immediate family" means (i) a spouse and
(ii) any other person who resides in the same household as the legislator and
who is a dependent of the legislator.
"Lobbyist relationship" means (i) an
engagement, agreement, or representation that relates to legal services,
consulting services, or public relations services, whether gratuitous or for
compensation, between a member or member-elect and any person who is, or has
been within the prior calendar year, registered as a lobbyist with the
Secretary of the Commonwealth or (ii) a greater than three percent ownership
interest by a member or member-elect in a business that employs, or engages as
an independent contractor, any person who is, or has been within the prior
calendar year, registered as a lobbyist with the Secretary of the Commonwealth.
The disclosure of a lobbyist relationship shall not (a) constitute a waiver of
any attorney-client or other privilege, (b) require a waiver of any
attorney-client or other privilege for a third party, or (c) be required where
a member or member-elect is employed or engaged by a person and such person
also employs or engages a person in a lobbyist relationship so long as the
member or member-elect has no financial interest in the lobbyist relationship.
TRUST. If you or your immediate family, separately
or together, are the only beneficiaries of a trust, treat the trust's assets as
if you own them directly. If you or your immediate family has a proportional
interest in a trust, treat that proportion of the trust's assets as if you own
them directly. For example, if you and your immediate family have a one-third
interest in a trust, complete your Statement as if you own one-third of each of
the trust's assets. If you or a member of your immediate family created a trust
and can revoke it without the beneficiaries' consent, treat its assets as if
you own them directly.
REPORT TO THE BEST OF INFORMATION AND BELIEF.
Information required on this Statement must be provided on the basis of the
best knowledge, information, and belief of the individual filing the Statement
as of the date of this report unless otherwise stated.
COMPLETE ITEMS 1 THROUGH 11. REFER TO SCHEDULES
ONLY IF DIRECTED.
You may attach additional explanatory information.
1. Offices and Directorships.
Are you or a member of your immediate family a paid
officer or paid director of a business?
EITHER check NO / / OR check YES / / and complete
Schedule A.
2. Personal Liabilities.
Do you or a member of your immediate family owe
more than $5,000 to any one creditor including contingent liabilities? (Exclude
debts to any government and loans secured by recorded liens on property at
least equal in value to the loan.)
EITHER check NO / / OR check YES / / and complete
Schedule B.
3. Securities.
Do you or a member of your immediate family,
directly or indirectly, separately or together, own securities valued in excess
of $5,000 invested in one business? Account for mutual funds, limited
partnerships and trusts.
EITHER check NO / / OR check YES / / and complete
Schedule C.
4. Payments for Talks, Meetings, and Publications.
During the past six months did you receive in your
capacity as a legislator lodging, transportation, money, or anything else of
value with a combined value exceeding $100 (i) for a single talk, meeting, or
published work or (ii) for a meeting, conference, or event where your
attendance at the meeting, conference, or event was designed to (a) educate you
on issues relevant to your duties as a legislator, including issues faced by
your constituents, or (b) enhance your knowledge and skills relative to your
duties as a legislator? Do not include payments and reimbursements from the
Commonwealth for meetings attended in your capacity as a legislator; see
Question 11 and Schedule D2 to report such meetings.
EITHER check NO / / OR check YES / / and complete
Schedule D.
5. Gifts.
During the past six months did a business,
government, or individual other than a relative or personal friend (i) furnish
you or a member of your immediate family with any gift or entertainment at a
single event, and the value received exceeded $50 or (ii) furnish you or a
member of your immediate family with gifts or entertainment in any combination
and the total value received exceeded $50, and for which you or the member of
your immediate family neither paid nor rendered services in exchange? Account
for entertainment events only if the average value per person attending the
event exceeded $50. Account for all business entertainment (except if related
to the private profession or occupation of you or the member of your immediate
family who received such business entertainment) even if unrelated to your
official duties.
EITHER check NO / / OR check YES / / and complete
Schedule E.
6. Salary and Wages.
List each employer that pays you or a member of
your immediate family salary or wages in excess of $5,000 annually. (Exclude
any salary received as a member of the General Assembly pursuant to §
30-19.11.)
If no reportable salary or wages, check here / /.
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________
7. Business Interests and Lobbyist Relationships.
7A. Do you or a member of your immediate family,
separately or together, operate your own business, or own or control an
interest in excess of $5,000 in a business?
EITHER check NO / / OR check YES / / and complete
Schedule F-1.
7B. Do you have a lobbyist relationship as that
term is defined above?
EITHER check NO / / OR check YES / / and complete
Schedule F-2.
8. Payments for Representation and Other Services.
8A. Did you represent any businesses before any
state governmental agencies, excluding courts or judges, for which you received
total compensation during the past six months in excess of $1,000, excluding
compensation for other services to such businesses and representation
consisting solely of the filing of mandatory papers and subsequent
representation regarding the mandatory papers?
EITHER check NO / / OR check YES / / and complete
Schedule G-1.
8B. Subject to the same exceptions as in 8A, did
persons with whom you have a close financial association (partners, associates
or others) represent any businesses before any state governmental agency for
which total compensation was received during the past six months in excess of
$1,000?
EITHER check NO / / OR check YES / / and complete
Schedule G-2.
8C. Did you or persons with whom you have a close
financial association furnish services to businesses operating in Virginia,
pursuant to an agreement between you and such businesses, or between persons
with whom you have a close financial association and such businesses for which
total compensation in excess of $1,000 was received during the past six months?
Services reported under this provision shall not include services involving the
representation of businesses that are reported under question 8A or 8B above.
EITHER check NO / / OR check YES / / and complete
Schedule G-3.
9. Real Estate.
Do you or a member of your immediate family hold an
interest, including a partnership interest, valued at more than $5,000 in real
property (other than your principal residence) for which you have not already
listed the full address on Schedule F? Account for real estate held in trust.
EITHER check NO / / OR check YES / / and complete
Schedule H.
10. Real Estate Contracts with State Governmental
Agencies.
Do you or a member of your immediate family hold an
interest valued at more than $5,000 in real estate, including a corporate,
partnership, or trust interest, option, easement, or land contract, which real
estate is the subject of a contract, whether pending or completed within the
past six months, with a state governmental agency?
If the real estate contract provides for the
leasing of the property to a state governmental agency, do you or a member of
your immediate family hold an interest in the real estate, including a
corporate, partnership, or trust interest, option, easement, or land contract
valued at more than $1,000? Account for all such contracts whether or not your
interest is reported in Schedule F or H. This requirement to disclose an
interest in a lease does not apply to an interest derived through an ownership
interest in a business unless the ownership interest exceeds three percent of
the total equity of the business.
EITHER check NO / / OR check YES / / and complete
Schedule I.
11. Payments by the Commonwealth for Meetings.
During the past six months did you receive lodging,
transportation, money, or anything else of value with a combined value
exceeding $100 from the Commonwealth for a single meeting attended out-of-state
in your capacity as a legislator? Do not include reimbursements from the
Commonwealth for meetings attended in the Commonwealth.
EITHER check NO / / OR check YES / / and complete
Schedule D-2.
For Statements filed in June 2016 and each two
years thereafter, complete the following statement indicating whether you
completed the ethics orientation sessions provided pursuant to law:
I certify that I completed ethics training as
required by § 30-129.1. YES / / or NO / /.
Statements of Economic Interests are open for
public inspection.
AFFIRMATION.
In accordance with the rules of the house in which
I serve, if I receive a request that this disclosure statement be corrected,
augmented, or revised in any respect, I hereby pledge that I shall respond
promptly to the request. I understand that if a determination is made that the
statement is insufficient, I will satisfy such request or be subjected to
disciplinary action of my house.
I swear or affirm that the foregoing information is
full, true and correct to the best of my knowledge.
Signature________________________________
(Return only if needed to complete Statement.)
SCHEDULES to STATEMENT OF ECONOMIC INTERESTS.
NAME__________________________________
SCHEDULE A -- OFFICES AND DIRECTORSHIPS.
Identify each business of which you or a member of
your immediate family is a paid officer or paid director.
_______________________________________________________________________
Name of Business Address of Business Position Held and by Whom
___________________ _____________________ _________________________
___________________ _____________________ _________________________
___________________ _____________________ _________________________
___________________ _____________________ _________________________
_______________________________________________________________________
RETURN TO ITEM 2
SCHEDULE B -- PERSONAL LIABILITIES.
Report personal liability by checking each
category. Report only debts in excess of $5,000. Do not report debts to any
government. Do not report loans secured by recorded liens on property at least equal
in value to the loan.
Report contingent liabilities below and indicate
which debts are contingent.
1. My personal debts are as follows:
______________________________________________________________________
Check Check one
appropriate $5,001 to More than
categories $50,000 $50,000
Banks __________ _________
Savings institutions __________ _________
Other loan or finance companies __________ _________
Insurance companies __________ _________
Stock, commodity or other brokerage
companies __________ _________
Other businesses:
(State principal business activity for each
creditor and its name.)
____________________________________________ __________ _________
____________________________________________ __________ _________
____________________________________________ __________ _________
Individual creditors:
(State principal business or occupation of
each creditor and its name.)
____________________________________________ __________ _________
____________________________________________ __________ _________
____________________________________________ __________ _________
______________________________________________________________________
2. The personal debts of the members of my immediate
family are as follows:
______________________________________________________________________
Check Check one
appropriate $5,001 to More than
categories $50,000 $50,000
Banks __________ _________
Savings institutions __________ _________
Other loan or finance companies __________ _________
Insurance companies __________ _________
Stock, commodity or other brokerage
companies __________ _________
Other businesses:
(State principal business activity for each
creditor and its name.)
____________________________________________ __________ _________
____________________________________________ __________ _________
____________________________________________ __________ _________
Individual creditors:
(State principal business or occupation of
each creditor and its name.)
____________________________________________ __________ _________
____________________________________________ __________ _________
____________________________________________ __________ _________
______________________________________________________________________
RETURN TO ITEM 3
SCHEDULE C -- SECURITIES.
"Securities" INCLUDES stocks, bonds,
mutual funds, limited partnerships, and commodity futures contracts.
"Securities" EXCLUDES certificates of
deposit, money market funds, annuity contracts, and insurance policies.
Identify each business or Virginia governmental
entity in which you or a member of your immediate family, directly or
indirectly, separately or together, own securities valued in excess of $5,000.
Name each issuer and type of security individually.
Do not list U.S. Bonds or other government
securities not issued by the Commonwealth of Virginia or its authorities,
agencies, or local governments. Do not list organizations that do not do
business in this Commonwealth, but most major businesses conduct business in
Virginia. Account for securities held in trust.
If no reportable securities, check here / /.
__________________________________________________________________________
Check one
Type of Security $5,001 $50,001 More
(stocks, bonds, mutual to to than
Name of Issuer funds, etc.) $50,000 $250,000 $250,000
______________________ _______________________ _______ _______ ________
______________________ _______________________ _______ _______ ________
______________________ _______________________ _______ _______ ________
______________________ _______________________ _______ _______ ________
__________________________________________________________________________
RETURN TO ITEM 4
SCHEDULE D-1 -- PAYMENTS FOR TALKS, MEETINGS, AND
PUBLICATIONS.
List each source from which you received during the
past six months in your capacity as a legislator lodging, transportation,
money, or any other thing of value with a combined value exceeding $100 (i) for
your presentation of a single talk, participation in one meeting, or
publication of a work or (ii) for your attendance at a meeting, conference, or
event where your attendance at the meeting, conference, or event was designed
to (a) educate you on issues relevant to your duties as a legislator, including
issues faced by your constituents, or (b) enhance your knowledge and skills
relative to your duties as a legislator. Any lodging, transportation, money, or
other thing of value received by a legislator that does not satisfy the
criteria of clause (i), (ii)(a), or (ii)(b) shall be listed as a gift on
Schedule E. Do not list payments or reimbursements by the Commonwealth. (See
Schedule D-2 for such payments or reimbursements.) List a payment even if you
donated it to charity. Do not list information about a payment if you returned
it within 60 days or if you received it from an employer already listed under
Item 6 or from a source of income listed on Schedule F.
If no payment must be listed, check here / /.
________________________________________________________________________
Type of Payment
(e.g., Honoraria,
Travel reimburse-
Payer Approximate Value Circumstances ment, etc.)
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________________________________________________________________
RETURN TO ITEM 5
SCHEDULE D-2 -- PAYMENTS BY THE COMMONWEALTH FOR
MEETINGS.
List each meeting for which the Commonwealth
provided payments or reimbursements during the past six months to you for
lodging, transportation, money, or any other thing of value with a combined
value exceeding $100 for your participation in your capacity as a legislator.
Do not list payments or reimbursements by the Commonwealth for meetings or
travel within the Commonwealth.
If no payment must be listed, check here / /.
________________________________________________________________________
Type of Payment
(e.g., Travel
reimbursement,
Payer Approximate Value Circumstances etc.)
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________ __________________ _______________ _________________
________________________________________________________________________
SCHEDULE E -- GIFTS.
List each business, governmental entity, or
individual that, during the past six months, (i) furnished you or a member of
your immediate family with any gift or entertainment at a single event, and the
value received exceeded $50 or (ii) furnished you or a member of your immediate
family with gifts or entertainment in any combination and the total value
received exceeded $50, and for which you or the member of your immediate family
neither paid nor rendered services in exchange. List each such gift or event.
Do not list entertainment events unless the average
value per person attending the event exceeded $50. Do not list business
entertainment related to the private profession or occupation of you or the
member of your immediate family who received such business entertainment. Do
not list gifts or other things of value given by a relative or personal friend
for reasons clearly unrelated to your public position. Do not list campaign
contributions publicly reported as required by Chapter 9.3 (§ 24.2-945 et seq.)
of Title 24.2 of the Code of Virginia.
__________________________________________________________________________
Name of Business, City or Exact
Name of Organization, or County Gift or Approximate
Recipient Individual and State Event Value
____________ __________________ __________ ___________ ___________
____________ __________________ __________ ___________ ___________
____________ __________________ __________ ___________ ___________
____________ __________________ __________ ___________ ___________
_________________________________________________ ________________________
RETURN TO ITEM 6
SCHEDULE F-1 -- BUSINESS INTERESTS.
Complete this Schedule for each self-owned or
family-owned business (including rental property, a farm, or consulting work),
partnership, or corporation in which you or a member of your immediate family,
separately or together, own an interest having a value in excess of $5,000.
If the enterprise is owned or operated under a
trade, partnership, or corporate name, list that name; otherwise, merely
explain the nature of the enterprise. If rental property is owned or operated
under a trade, partnership, or corporate name, list the name only; otherwise,
give the address of each property. Account for business interests held in
trust.
_________________________________________________________________________
Name of
Business
Corporation,
Partnership, Nature of Gross income
Farm; Enterprise
Address of City or (farming, $50,001 More
Rental County law, rental $50,000 to than
Property and State property, etc.) or less $250,000 $250,000
______________ _________ _________________ _______ ________ ________
______________ _________ _________________ _______ ________ ________
______________ _________ _________________ _______ ________ ________
______________ _________ _________________ _______ ________ ________
_________________________________________________________________________
RETURN TO ITEM 8
SCHEDULE F-2 -- LOBBYIST RELATIONSHIPS AND
PAYMENTS.
Complete this Schedule for each lobbyist
relationship with the following:
(i) any person who is, or has been within the prior
calendar year, registered as a lobbyist with the Secretary of the Commonwealth,
or
(ii) any business in which you have a greater than
three percent ownership interest and that business employs, or engages as an
independent contractor, any person who is, or has been within the prior
calendar year, registered as a lobbyist with the Secretary of the Commonwealth.
___________________________________________________________________________
Payments to
Lobbyist
List each person Describe each Dates of $10,000 More than
or business relationship relationship or less $10,000
_________________ ______________ ______________ ___________ ___________
_________________ ______________ ______________ ___________ ___________
_________________ ______________ ______________ ___________ ___________
_________________ ______________ ______________ ___________ ___________
_________________ ______________ ______________ ___________ ___________
___________________________________________________________________________
THE DISCLOSURE OF A LOBBYIST RELATIONSHIP SHALL NOT
(I) CONSTITUTE A WAIVER OF ANY ATTORNEY-CLIENT OR OTHER PRIVILEGE, (II) REQUIRE
A WAIVER OF ANY ATTORNEY-CLIENT OR OTHER PRIVILEGE FOR A THIRD PARTY, OR (III)
BE REQUIRED WHERE A MEMBER OR MEMBER-ELECT IS EMPLOYED OR ENGAGED BY A PERSON
AND SUCH PERSON ALSO EMPLOYS OR ENGAGES A PERSON IN A LOBBYIST RELATIONSHIP SO
LONG AS THE MEMBER OR MEMBER-ELECT HAS NO FINANCIAL INTEREST IN THE LOBBYIST
RELATIONSHIP.
SCHEDULE G-1 -- PAYMENTS FOR REPRESENTATION BY YOU.
List the businesses you represented before any
state governmental agency, excluding any court or judge, for which you received
total compensation during the past six months in excess of $1,000, excluding
compensation for other services to such businesses and representation
consisting solely of the filing of mandatory papers and subsequent
representation regarding the mandatory papers filed by you.
Identify each business, the nature of the
representation and the amount received by dollar category from each such
business. You may state the type, rather than name, of the business if you are
required by law not to reveal the name of the business represented by you.
______________________________________________________________________
Pur-
pose Amount Received
Name Type of
of of Repre- Name $1,001 $10,001 $50,001 $100,001
Busi- Busi- senta- of to to to to $250,001
ness ness tion Agency $10,000 $50,000 $100,000 $250,000 and over
______ ______ ______ ______ _______ _______ ________ ________ ________
______ ______ ______ ______ _______ _______ ________ ________ ________
______ ______ ______ ______ _______ _______ ________ ________ ________
______ ______ ______ ______ _______ _______ ________ ________ ________
______________________________________________________________________
If you have received $250,001 or more from a single
business within the reporting period, indicate the amount received, rounded to
the nearest $10,000. Amount Received __________.
SCHEDULE G-2 -- PAYMENTS FOR REPRESENTATION BY
ASSOCIATES.
List the businesses that have been represented
before any state governmental agency, excluding any court or judge, by persons
who are your partners, associates or others with whom you have a close
financial association and who received total compensation in excess of $1,000
for such representation during the past six months, excluding representation
consisting solely of the filing of mandatory papers and subsequent
representation regarding the mandatory papers filed by your partners,
associates or others with whom you have a close financial association.
Identify such businesses by type and also name the
state governmental agencies before which such person appeared on behalf of such
businesses.
______________________________________________________________________
Type of Business Name of State Governmental Agency
_____________________________ ______________________________________
_____________________________ ______________________________________
_____________________________ ______________________________________
_____________________________ ______________________________________
______________________________________________________________________
SCHEDULE G-3 -- PAYMENTS FOR OTHER SERVICES
GENERALLY.
Indicate below types of businesses that operate in
Virginia to which services were furnished by you or persons with whom you have
a close financial association pursuant to an agreement between you and such
businesses, or between persons with whom you have a close financial association
and such businesses and for which total compensation in excess of $1,000 was
received during the past six months. Services reported in this Schedule shall
not include services involving the representation of businesses that are
reported in Schedule G-1 or G-2 above.
Identify opposite each category of businesses
listed below (i) the type of business, (ii) the type of service rendered and
(iii) the value by dollar category of the compensation received for all
businesses falling within each category.
__________________________________________________________________________
Check
if Type
ser- of Value of Compensation
vices ser-
were vice $1,001 $10,001 $50,001 $100,001
ren- ren- to to to to $250,001
dered dered $10,000 $50,000 $100,000 $250,000 and over
Electric utilities _____ _____ _______ _______ ________ ________ ________
Gas utilities _____ _____ _______ _______ ________ ________ ________
Telephone utilities _____ _____ _______ _______ ________ ________ ________
Water utilities _____ _____ _______ _______ ________ ________ ________
Cable television
companies _____ _____ _______ _______ ________ ________ ________
Interstate
transportation
companies _____ _____ _______ _______ ________ ________ ________
Intrastate
transportation
companies _____ _____ _______ _______ ________ ________ ________
Oil or gas retail
companies _____ _____ _______ _______ ________ ________ ________
Banks _____ _____ _______ _______ ________ ________ ________
Savings
institutions _____ _____ _______ _______ ________ ________ ________
Loan or finance
companies _____ _____ _______ _______ ________ ________ ________
Manufacturing
companies (state
type of product,
e.g., textile,
furniture, etc.) _____ _____ _______ _______ ________ ________ ________
Mining companies _____ _____ _______ _______ ________ ________ ________
Life insurance
companies _____ _____ _______ _______ ________ ________ ________
Casualty insurance
companies _____ _____ _______ _______ ________ ________ ________
Other insurance
companies _____ _____ _______ _______ ________ ________ ________
Retail companies _____ _____ _______ _______ ________ ________ ________
Beer, wine or
liquor companies
or distributors _____ _____ _______ _______ ________ ________ ________
Trade associations _____ _____ _______ _______ ________ ________ ________
Professional
associations _____ _____ _______ _______ ________ ________ ________
Associations of
public employees
or officials _____ _____ _______ _______ ________ ________ ________
Counties, cities
or towns _____ _____ _______ _______ ________ ________ ________
Labor organizations _____ _____ _______ _______ ________ ________ ________
Other _____ _____ _______ _______ ________ ________ ________
__________________________________________________________________________
RETURN TO ITEM 9
SCHEDULE H -- REAL ESTATE.
List real estate other than your principal
residence in which you or a member of your immediate family holds an interest,
including a partnership interest, option, easement, or land contract, valued at
$5,000 or more. Each parcel shall be listed individually.
________________________________________________________________________
Describe the type of real
estate you own in each
List the location location (business, If the real estate is
(state, and county recreational, apartment, owned or recorded in
or city where you commercial, open land, a name other than your
own real estate etc.) own, list that name
___________________ _________________________ ______________________
___________________ _________________________ ______________________
___________________ _________________________ ______________________
___________________ _________________________ ______________________
___________________ _________________________ ______________________
________________________________________________________________________
RETURN TO ITEM 10
SCHEDULE I -- REAL ESTATE CONTRACTS WITH STATE
GOVERNMENTAL AGENCIES.
List all contracts, whether pending or completed
within the past six months, with a state governmental agency for the sale or
exchange of real estate in which you or a member of your immediate family holds
an interest, including a corporate, partnership or trust interest, option,
easement, or land contract, valued at more than $10,000. List all contracts
with a state governmental agency for the lease of real estate in which you or a
member of your immediate family holds such an interest valued at more than
$1,000. This requirement to disclose an interest in a lease does not apply to
an interest derived through an ownership interest in a business unless the
ownership interest exceeds three percent of the total equity of the business.
_______________________________________________________________________
List your real
estate interest and
the person or entity,
including the type of
entity, which is
party to the contract. State the annual
Describe any income from the
management role and List each contract, and the
the percentage governmental agency amount, if any, of
ownership interest which is a party to income you or any
you or your immediate the contract and immediate family
family member has in indicate the county member derives
the real estate or city where the annually from
or entity. real estate is located. the contract.
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
______________________ ________________________ ___________________
_______________________________________________________________________
B. Any legislator who knowingly and intentionally makes a false statement of a material fact on the Statement of Economic Interests is guilty of a Class 5 felony and shall be subject to disciplinary action for such violations by the house in which the legislator sits.
C. The Statement of Economic Interests of all members of each house shall be reviewed by the Council. If a legislator's Statement is found to be inadequate as filed, the legislator shall be notified in writing and directed to file an amended Statement correcting the indicated deficiencies, and a time shall be set within which such amendment shall be filed. If the Statement of Economic Interests, in either its original or amended form, is found to be adequate as filed, the legislator's filing shall be deemed in full compliance with this section as to the information disclosed thereon.
D. Ten percent of the membership of a house, on the basis of newly discovered facts, may in writing request the house in which those members sit, in accordance with the rules of that house, to review the Statement of Economic Interests of another member of that house in order to determine the adequacy of his filing. In accordance with the rules of each house, each Statement of Economic Interests shall be promptly reviewed, the adequacy of the filing determined, and notice given in writing to the legislator whose Statement is in issue. Should it be determined that the Statement requires correction, augmentation or revision, the legislator involved shall be directed to make the changes required within such time as shall be set under the rules of each house.
If a legislator, after having been notified in writing in accordance with the rules of the house in which he sits that his Statement is inadequate as filed, fails to amend his Statement so as to come into compliance within the time limit set, he shall be subject to disciplinary action by the house in which he sits. No legislator shall vote on any question relating to his own Statement.
§ 30-356. Powers and duties of the Council.
The Council shall:
1. Prescribe the forms required for complying with the disclosure requirements of Article 3 and the Acts. These forms shall be the only forms used to comply with the provisions of Article 3 or the Acts. The Council shall make available the disclosure forms and shall provide guidance and other instructions to assist in the completion of the forms;
2. Review all disclosure forms filed by lobbyists pursuant to Article 3 and by state government officers and employees and legislators pursuant to the Acts. The Council may review disclosure forms for completeness, including reviewing the information contained on the face of the form to determine if the disclosure form has been fully completed and comparing the disclosures contained in any disclosure form filed by a lobbyist pursuant to § 2.2-426 with other disclosure forms filed with the Council, and requesting any amendments to ensure the completeness of and correction of errors in the forms, if necessary. If a disclosure form is found to have not been filed or to have been incomplete as filed, the Council shall notify the filer in writing and direct the filer to file a completed disclosure form within a prescribed period of time, and such notification shall be confidential and is excluded from the provisions of the Virginia Freedom of Information Act (§ 2.2-3700 et seq.);
2. 3. (Effective
until July 1, 2016) Accept any disclosure forms by computer or electronic means
in accordance with the standards approved by the Council and using software
meeting standards approved by it. The Council shall provide software or
electronic access for filing the required disclosure forms to all filers
without charge. The Council shall prescribe the method of execution and
certification of electronically filed forms, including the use of an electronic
signature as authorized by the Uniform Electronic Transactions Act (§ 59.1-479
et seq.);
2. 3. (Effective
July 1, 2016) Require all disclosure forms to be filed electronically in
accordance with the standards approved by the Council. The Council shall
provide software or electronic access for filing the required disclosure forms
to all filers without charge. The Council shall prescribe the method of
execution and certification of electronically filed forms, including the use of
an electronic signature as authorized by the Uniform Electronic Transactions
Act (§ 59.1-479 et seq.);
3. 4. Accept
and review any statement received from a filer disputing the receipt by such
filer of a gift that has been disclosed on the form filed by a lobbyist
pursuant to Article 3;
4. 5. Beginning
July 1, 2016, establish and maintain a searchable electronic database
comprising disclosure forms filed pursuant to §§ 2.2-426, 2.2-3117, 2.2-3118,
and 30-111. Such database shall be available to the public through the
Council's official website;
5. 6. Furnish,
upon request, formal advisory opinions or guidelines and other appropriate
information, including informal advice, regarding ethics, conflicts issues
arising under Article 3 or the Acts, or a person's duties under Article 3 or
the Acts to any person covered by Article 3 or the Acts or to any agency of
state or local government, in an expeditious manner. The Council may authorize
a designee to furnish formal opinions or informal advice. Formal advisory
opinions are public record and shall be published on the Council's website;
however, no formal advisory opinion furnished by a designee of the Council
shall be published until such opinion has been approved by the Council.
Published formal advisory opinions may have such deletions and changes as may
be necessary to protect the identity of the person involved. Informal advice
given by the Council or the Council's designee is confidential, protected by
the attorney-client privilege, and is excluded from the provisions of the
Virginia Freedom of Information Act (§ 2.2-3700 et seq.);
6. 7. Conduct
training seminars and educational programs for lobbyists, state and local
government officers and employees, legislators, and other interested persons on
the requirements of Article 3 and the Acts and provide ethics orientation
sessions for legislators in compliance with Article 6 (§ 30-129.1 et seq.) of
Chapter 13;
7. 8. Approve
orientation courses conducted pursuant to § 2.2-3128 and, upon request, review
the educational materials and approve any training or course on the
requirements of Article 3 and the Acts conducted for state and local government
officers and employees;
8. 9. Publish
such educational materials as it deems appropriate on the provisions of Article
3 and the Acts;
9. 10. Review
actions taken in the General Assembly with respect to the discipline of its
members for the purpose of offering nonbinding advice;
10. 11. Request
from any agency of state or local government such assistance, services, and
information as will enable the Council to effectively carry out its
responsibilities. Information provided to the Council by an agency of state or
local government shall not be released to any other party unless authorized by
such agency;
11. 12. Redact
from any document or form that is to be made available to the public any
residential address, personal telephone number, or signature contained on that
document or form; and
12. 13. Report
on or before December 1 of each year on its activities and findings regarding Article
3 and the Acts, including recommendations for changes in the laws, to the
General Assembly and the Governor. The annual report shall be submitted by the
chairman as provided in the procedures of the Division of Legislative Automated
Systems for the processing of legislative documents and reports and shall be
published as a state document.
2. That the provisions of this act shall become effective on January 1, 2017.
3. That the Virginia Conflict of Interests and Ethics Advisory Council shall prescribe on or before January 1, 2017, the forms required for complying with the disclosure requirements of §§ 2.2-426, 2.2-3117, 2.2-3118, and 30-111 of the Code of Virginia.